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[Scaphoid fracture and scaphoid pseudarthrosis]
A Eisenschenk1, M Lautenbach, U Weber
1Abteilung für Hand-, Replantations- und Mikrochirurgie, Unfallkrankenhaus, Berlin.
Der Orthopade
|November 7, 1999
Summary
Early diagnosis and treatment of scaphoid fractures are crucial. Herbert screw fixation shows good results for scaphoid fractures and non-unions, with MRI aiding prognosis.
Area of Science:
- Orthopedic surgery
- Radiology
- Sports medicine
Background:
- Scaphoid fractures in young patients often lead to non-unions.
- Early diagnosis and therapy are critical for optimal outcomes.
- Conservative and operative treatments are available.
Purpose of the Study:
- To evaluate the effectiveness of Herbert screw fixation for scaphoid fractures and non-unions.
- To assess the utility of MRI in predicting outcomes.
- To correlate pre-operative MRI findings with fusion rates.
Main Methods:
- Retrospective study of 42 scaphoid fracture and 88 non-union patients (1993-1999).
- Standard X-ray, clinical examination, and pre/post-operative MRI were used.
- Scaphoid fractures treated with Herbert screw fixation; non-unions with iliac crest graft and Herbert screw fixation.
Main Results:
- Good to excellent post-operative results for scaphoid fractures.
- Lower fusion rates in non-union patients with pre-operative MRI signal reduction in the proximal fragment.
- Herbert screw fixation achieved bony fusion in most cases.
Conclusions:
- Herbert screw fixation is effective for scaphoid fractures and non-unions.
- MRI can supplement radiological classification and aid in prognosis.
- Pre-operative MRI signal reduction may indicate a poorer prognosis for fusion.